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everett <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or pnit clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. ��c 13f '1f ' <br />APPLICANT (UNDERSIGNED( AND FIRM REPRESENTED, IF ANY: . I I ii [/ )I l J, III U/K/ /yit'i <br />HEREBY APPLIES FOR PERMISSION TO A, ZIa[Jf L 1 � Wl. I- k (I _I- [ 1 r / Ll Cl? r <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />I c-_� G r_. /L,Li?c< i ✓. 19�f`n� <br />•OMIi�i fi 76`, 69 <br />Existing alley is not to be altered by widening or changing vertical grades. <br />Allowable work is limited to minor grading, clearing back overgrowth, and <br />adding 5/8" minus crushed rock to improve driving surface. <br />PERMIT IS VALID FOR GO DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-08 Y i <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER <br />DRAINAGE <br />WATER -- <br />STREET <br />COMMUNICATIONS <br />TRAFFIC <br />PLANNING <br />APPROVED CON TRUCTION AtE <br />DRIVEWAY SECTION <br />1" LIP <br />30'ibiT_ _f_30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages. costs. <br />e Fpenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other righl-of-way use <br />hereto Applied for and further agrees to remove same upon nonce <br />from the City and to replace public property damaged thereby <br />APPROVED AS CONSTRUCTED DATE <br />TELEPHONE NUMBER .. ALTERNATE <br />DATE <br />